English:
Paracetamol Paracetamol is an anti-pyretic and analgesic. but has no anti- inflammatory action. is synthetic drug that has been in It a clinical use for more than a century. but its mode of action is still unclear. It is known the central nervous system and has to act via effects on cox pathways. stimulates descending inhibitory pathways via serotonin and inhibits substance P. but which of these is the predominant mechanism has yet to be clarified Paracetamol is well tolerated. has few side-effects in very clinical doses and very few contraindications (hypersensitivity to paracetamol and severe hepatic dysfunction). In addition. it is very cheap (approximately 40.02 per 1000 mg). oral paracetamol is readily absorbed with a bioavailability of between 60% and 90% and achieves a maximum plasma concentration (Tma.) in 30-120 min. Furthermore, it has a substantial effect on the NNTs of both codeine and tramadol (Table 2).There is some evidence to suggest that paracetamol administered regularly (for example 1000 mg every 6 hours in individuals over 50 kg) is more eftective than when it is given only as required. Paracetamol. either alone or in combination, should be prescribed for every patient with postoperative pain unless there is a specific contraindication Paracetamol is also available in an intravenous form. Randomized controlled trials (RCTs) have demonstrated that. when compared to the oral form. the intravenous preparation has a more rapid onset of action and produces superior early (60-240 min) analgesia. There is no evidence. however. that repeated use of intravenous paracetamol is superior to the oral form. Intravenous paracetamol should be reserved for patients who are not able to take oral medication or as part of a plan for rapid pain control when a patient has severe pain. Paracetamol is also available as suppositories but these have a slow onset of action. very variable absorption and no cost advantage over the intravenous form so the suppositories have little or no clinical use